In many instances, it is difficult if not impossible to administer medication in capsule form to patients. This is particularly true for patients who may be comatose or otherwise physically unable to swallow the pills. For those people, in the prior art, the pills were ground with a mortar and pestle. The powder was transferred to a liquid-filled container and mixed with the liquid. The suspension was then either swallowed, or a syringe was filled with the suspension and injected into an intravenous tube or other tube generally used in hospital settings.
The prior art technique carried several drawbacks. The most serious of these were the risks of low and unpredictable compliance and cross-contamination. As the pill was crushed in a mortar and then transferred to another container before being administered, a nurse using extreme care could not help but lose some of the pill as residue on the mortar, pestle, etc. Furthermore, this residue would necessarily vary both in quantity and content from dose to dose to thereby perhaps alter the dosage administered from that intended. In extreme situations, this could interfere with achieving the desired medical result.
The undesired, but inescapable, residue also created an unavoidable risk of cross-contamination as the same mortar and pestle were typically re-used for the same and other patients, as well.
Moreover, the prior art technique was very time consuming as the nurse needed to use care and caution to avoid spillage, which translated into increased nurse or medical technician time and expense.
Other pill crushing devices are also known in the prior art. However, similar to the mortar and pestle technique discussed above, these devices were designed to grind or crush the pill in one compartment, transfer the powder to another liquid-filled container where the powder was dissolved or suspended and then administered. These devices similarly carried the risks of contamination, cross-contamination, spillage and waste, and were again time consuming.
The invention disclosed in the parent hereto, as cross-referenced above, overcomes the foregoing problems by providing a pill crushing syringe which is adapted to crush medication, preferably a pill, and mix the resulting powder with liquid all within the syringe itself, and then administer the suspension with the same syringe. Generally the syringe disclosed in the parent includes a barrel and a plunger. The syringe has two opposing abraded surfaces, one on the plunger and one in the barrel bottom, to crush a pill placed in the barrel by the plunger as it is advanced to the bottom of the barrel. The pill could even be "ground" by rotating the plunger within the barrel to achieve a complete breakdown of the pill into small and regularly sized particles. In an alternate embodiment of the invention disclosed in the parent, the bottom of the barrel may be threaded so that it may also be rotated, thereby permitting both abraded surfaces to be positively driven with respect to each other. The barrel includes an aperture and a catheter located at the bottom of the barrel for drawing liquid into the barrel to mix with the crushed pill particles. The plunger includes a sealing gland providing an airtight relationship between the plunger and the barrel to assist in drawing liquid into the barrel by withdrawing the plunger from the barrel when the catheter tip is submerged in the liquid. The suspension of the liquid and crushed pill particles is administered by advancing the plunger into the barrel thereby forcing the suspension through the catheter and into a tube attached to the patient.
Generally, the method of the invention disclosed in the parent comprises providing a pill crushing syringe including a barrel and a plunger with opposing abraded surfaces so that medication, preferably a pill, placed in the barrel is crushed as the plunger is "bottomed" within the barrel, placing a pill into the barrel, crushing the pill, adding liquid to the barrel thereby suspending the powder in the liquid, and flushing the suspension.
The apparatus and method of the parent invention are significant improvements over the prior art in that pills are crushed, the resulting powder mixed with liquid, and the suspension administered all with the same syringe. Because the pill is crushed in a closed container and the powder need not be transferred for mixing with the liquid, the risk of cross-contamination and spillage is greatly reduced while consistency of compliance is achieved. Moreover, the abraded surfaces used to crush the pills are exposed to the liquid drawn into the barrel which provides a "washing" action on the very surfaces used to grind the pill. This helps to minimize residue.
In addition to reducing the risk of waste and contamination, insuring a high dosage compliance rate, and eliminating the problem of cleaning the pestle and mortar, the invention disclosed in the parent saves nurses time allowing more medicinal dosages to be administered within the same time frame in a reliable manner. Further, the syringe may be made of plastic and used only once, thereby eliminating the risk of cross-contamination.
Building on the invention disclosed in the parent, the inventors have improved their earlier pill crushing syringe by providing a bi-level barrel having an open end, a closed end and a cylindrical wall, and a mating bi-level plunger having a tip end. As in the parent, the syringe has two opposing abraded surfaces, one on the plunger tip end and one on the barrel closed end to thereby crush a pill placed in the barrel as the plunger is advanced and rotated within the barrel. The present invention further includes an aperture through the barrel wall in spaced relation to the closed barrel end such that a pocket is formed by the barrel wall and the closed end between the aperture and the closed end. A substantially straight catheter is connected around and extends from the aperture. By holding the syringe upright, the crushed pill ingredients remain in this pocket prior to aspiration, thereby assuring high dosage integrity by prohibiting medication from escaping through the catheter.
In the parent, the preferred location of the aperture is adjacent the barrel closed end, and a "crooked" catheter is preferred to assure no medication escapes prior to aspiration. The "crooked" catheter arrangement provides quite favorable results. However, the pocket between the aperture and the barrel closed end of the present invention attains equally favorable dosage integrity while allowing the use of a substantially straight catheter. The straight catheter design is better suited for present injection molding technology and thus is significantly less expensive to manufacture.
An alternative embodiment of the present invention provides an alternative means for crushing the pill into a powder. This embodiment provides a bi-level barrel and a bi-level plunger, wherein the barrel further includes a side opening with a hollow side arm extending from the side opening. A reinforced barrel wall section having an interior abraded surface is positioned opposite the side opening. A side entry plunger having an abraded tip end is movable within the side arm and the side entry plunger is adapted to engage the reinforced wall abraded surface as the side entry plunger advances within the hollow arm and into the barrel. A pill placed between the reinforced wall abraded surface and the side entry plunger abraded tip end is crushed as the side entry plunger is advanced into and rotated within the barrel.
Another alternative embodiment provides a cylinder with two plungers having opposing abraded tip ends adapted to crush a pill placed therebetween by advancing the plungers within the cylinder and rotating the plungers in opposite directions. A catheter is connected around and extends from an aperture through the cylinder wall. A space between the two plungers, which encompasses the crushed pill ingredients, may be positioned to be in fluid connection with the aperture thereby allowing aspiration of the pill ingredients.